Carnegie Mellon University

Medical Plans

Eligible faculty and staff members can choose from several plan options.

Eligibility

You must be full-time benefits eligible (37.5 scheduled hours per week) or part-time benefits eligible (at least 17.5 scheduled hours per week) to enroll in medical plans. Shuttle drivers and members of the Campus Police Association must be scheduled to work 40 hours per week to be full-time benefits eligible.

Medical Plan Options

View the Medical Coverage Comparison Chart and Medical Plan Resources for more information.

Plan Type

Description

Preferred Provider Organization (PPO)

PPO plans give you the flexibility to use in- or out-of-network providers without referrals. A higher level of benefits is provided when in-network providers are used, resulting in lower out-of-pocket costs for you.

  • PPO plans are available through both Highmark and UPMC.
Health Maintenance Organization (HMO) / Exclusive Provider Organization (EPO)

HMO/EPO plans have low out-of-pocket expenses (no deductible or coinsurance) but do not provide benefits if you use out-of-network providers (except in the case of an emergency). Referrals to specialist care and related services are not required in most circumstances.

  • Plans are available through both Highmark and UPMC:
    • The UPMC HMO is available to faculty and staff in Western Pennsylvania only.
    • The Highmark EPO is available to faculty and staff at all domestic locations.
High Deductible PPO with Health Savings Account (HSA)

High-Deductible PPO plans have a higher deductible and a lower monthly premium. Once your health care expenses for the year exceed your deductible, the PPO plan begins paying benefits. CMU offers a Health Savings Account (HSA) that you can use to help pay for eligible deductible expenses. An HSA is a federally tax-deferred, private savings account designed to give you a way to pay for eligible medical, prescription, dental and vision expenses with tax-free dollars. You decide how much to put in your account (based on IRS limits set each year), and you retain ownership of the account even if you leave CMU or retire.

  • HSA plans are available through both Highmark and UPMC.
  • View the HSA Overview [pdf] for more information.

Medical Plan Contacts and Provider Search Tools

Highmark Blue Cross/Blue Shield

UPMC Health Plan